From the Research
An 1800 kcal total parenteral nutrition (TPN) solution would typically provide approximately 225 grams of total macronutrients, with a recommended distribution of about 90 grams of protein, 45 grams of lipids, and 90 grams of dextrose, as supported by the most recent and highest quality study 1. The exact distribution may vary based on the patient's clinical condition and metabolic needs.
- Protein requirements are typically calculated at 1.2-2.0 g/kg/day for most adults, with higher amounts for critically ill or malnourished patients.
- Lipids provide essential fatty acids and a concentrated source of calories, while dextrose provides the remainder of the caloric needs.
- The specific formulation should be tailored to the individual patient's requirements, considering factors such as renal function, hepatic function, fluid status, and underlying medical conditions.
- TPN solutions also contain electrolytes, vitamins, and trace elements to meet complete nutritional needs, as noted in various studies 2, 3, 4, 5. However, the most recent and highest quality study 1 suggests that a hypocaloric, high-protein diet is the most advantageous recommendation, which may impact the exact distribution of macronutrients in the TPN solution.
- The maintenance of blood glucose concentrations at 120-150 mg/dL is also an important factor for reducing morbidity, as accomplished with the use of insulin and lower doses of glucose 1.